Director, Escalated Provider Issue Resolution

Hi, we're Oscar. We're hiring a Senior Director, Escalated Provider Issue Resolution to join our Network & Provider Management team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Senior Director, Escalated Provider Issue Resolution team supports strategic provider accounts, high-complexity escalations, root-cause remediation, and provider service governance. This role will build and scale the operating model for escalated provider issue resolution, lead a multi-disciplinary team, and partner across Claims, Network, Utilization Management, Payment Integrity, Contact Center, Account Management, Technology, Analytics, and senior leadership to improve how Oscar identifies, routes, resolves, and prevents provider issues. This position will report to the SVP, Network and Provider Management.

You will report into the Vice President of Provider Integration & Experience.

Work Location: This is a remote position, open to candidates who reside in: Dallas, Texas. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The base pay for this role is: $196,732 - $258,211 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

• Lead and develop a multi-disciplinary provider issue resolution organization, including teams focused on strategic provider support, complex issue resolution, root-cause remediation, and provider service governance.
• Build a scalable operating model for escalated provider issues, including intake standards, triage criteria, escalation pathways, ownership expectations, service metrics, and closure practices.
• Oversee resolution of high-impact provider issues that require coordination across multiple operational teams.
• Partner with leaders across Claims, Network, Utilization Management, Payment Integrity, Contact Center, Account Management, Technology, and Analytics to improve handoffs, reduce avoidable escalations, and address recurring root causes.
• Oversee root-cause remediation by analyzing escalated issue trends, prioritizing fixes based on provider impact and enterprise ROI, and driving cross-functional follow-through on the highest-value operational improvements.